Edge-Notes Day 3

Third day, third camp.  Each has its own subtle unique atmosphere, a combination of it's age and size perhaps, or of the NGO which "runs" it.  Today's camp is the purview of MSF, and is one of the larger ones.  More spread out, more space, a bustling market.  Humans are humans, put 150 thousand of them together and they will begin selling things to each other.  The hospital compound is thoroughly fenced and heavily guarded.  this feels more like one thinks a refugee camp would.  The buildings are plank on cement, not permanent.  Dust, tents, thorny scrub bushes.  Open rafters, naked bulbs for lights, plank benches, cluttered tables.  Perhaps because MSF normally works in war zones and disasters, this hospital has that feel.  But in spite of the external shabbiness the level of care is excellent.  The Medical Officer in charge started one month ago, and gives his opinion that this hospital has more supplies and better outcomes than any provincial government hospital in Kenya.  There are 72 malnourished children admitted in three long barn-like wards.  Only one child has died from malnutrition in the last month.  That is impressive.  The numbers are considerably down from the peak of the post-drought crisis of 2011, but this is still the most malnourished patients I've ever seen in one place.  There is a sense of order and calm, of protocol, good records, plenty of space and supplies.  These people know what they are doing.

And perhaps because of that, they are confident in their abilities, less desperate for input.  A crowd comes to my newborn resuscitation workshop, and there is good interaction and teaching, laughter and interest as they practice with the model babies.  But after the first hour, we take a break, and when I offer another topic (something eagerly requested in the other camps) the 30 or so nursses, CO's and doctors seem to drift away, busy with their own world.  They used to have lots of MSF-employed temporary doctors, so perhaps they are more used to people coming in and out.  In the last year this has changed, however, due to the insecurity of the borders and the camps.  Now, like all the other camps, there is a small army of Kenyan workers employed by the NGO's, and the expatriates stay at the base in Dadaab and make brief escorted forays into the camp proper.

Today we have to finish by noon.  There is the usual confusion of the returning convoy, the speeding along the rough road, the clouds of dust, the discussion in the vehicle about whether to wait for the police or not.  We fly by fences and thorn scrubs, rounded huts, donkey carts stacked with firewood sticks, bright-scarved women, listless goats.  The refugees themselves must stay in the camps, but there are ethnically related Kenyans who have lived in this border area for a generation or more who move back and forth.  We are deposited safely back at our base camp just in time for lunch in the small screened "mess".  

And just in time for the most surreal moment of the day.  The "mess" is a rickety wooden building with screen windows, a stove and counter, a table and plastic chairs.  And a TV, hooked up to satellite channels.  There is a loud TV blaring wherever the NGO workers gather.  This time as we're washing our hands, we become aware of the news story.   "Attack in Dadaab" reads the title banner, beneath pictures of wounded police being loaded into an ambulance.  What?  There we are standing smack in the middle of Dadaab, hearing about a 2 hour gun battle via TV.  It seems that Somali bandits crossed the border and attacked vehicles on the road 10 km outside of town, so the police responded, with numerous injuries on both sides.  

A bizarre feeling.  Life was going on as "normal" as it could, people eating lunch and chatting, while we learned of local insecurity via the media.  Thankfully we were flying out.  

And within an hour we were back at the airfield where we started, huddled under the only shade around with about 40 people all waiting for the plane.  A few Norwegians and other Europeans, us, and MANY Kenyans, all young and casual and smart, checking their phone messages, planning their arrivals in Nairobi, interacting familiarly with one another.  

And then the cool air of Nairobi, the traffic, the relief of being back in a more comfortable and recognizable place.  I'm thankful to have had the opportunity to see the AID world, the refugee world, the remote NE Kenyan world.  To have taught life-saving skills to almost a hundred health workers.  To bear witness  to the reality of this life.  To contribute in a small way to the health capacity of the 2nd or 3rd largest population center in Kenya, and an area that represents 5% of the population of Somalia.  To spend time with surgeons I respect and admire, and with my son.

But mostly I'm thankful to be home.